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Clippings Indian Pediatrics 2001; 38: 317-318 |
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• Fat may be ‘bad’, but thin is not ‘in’! A study undertaken to explore the influence of maternal body size, size at birth, and childhood growth on future risk for schizophrenia revealed that low childhood BMI was an independent predictor of schizophrenia, while low late-pregnancy maternal BMI and small body size at birth had attenuated effects. The authors conclude that indicators of intrauterine and childhood undernutrition are associated with an increased lifetime risk of schizophrenia (Arch Gen Psychiatry 2001; 58: 48) • What type of delivery intervention is better, vaccum extraction or forceps? Surprisingly the answer may be different from an obstetrician’s perspective versus that of a pediatrician. In a large study from Canada with delivery information on 305,391 deliveries, 31,015 were delivered by vaccum extraction, and 18,727 were delivered by forceps. The authors conclude that vaccum extraction causes less maternal trauma but may increase the risk of cephalhematoma and certain types of intracranial hemorrhage (e.g., subarachnoid hemorrhage) (Am J Epid 2001; 153: 103). • Cisapride has been the center of controversy as far as its use in neonates is concerned. A recent study in 20 low birth weight preterm infants with mean gestational age of 30.5 wk and birthweight of 1320 g showed that Cisapride significantly shortened both gastric emptying time and QTc interval (p <0.05) compared to placebo. All infants completed the study without any apparent adverse effects. In conclusion, low-dose Cisapride administration significantly improves gastric emptying without increasing the QTc interval (Acta Paediatr 2001; 89:1446). • Severely hypothyroid neonates may have impaired renal functions. Eighty hypothyroid infants detected during routine neonatal screening (16 severely hypothyroid; SHT) were compared with 20 controls. Serum Creatinine (SCr) levels were significantly higher in the SHT group (p <0.001) compared with the MHT group and normal control group. Two months after the LT4 replacement therapy, the elevated SCr levels in the SHT group decreased by 41.3% to the level (19.5 ± 6.0 µmol/L) very close to that in the MHT group ( 18.8 ± 5.1 µmol/L). No significant differences were noted among BUN levels in the three groups. The possibility of impaired renal functions should be kept in mind when treating hypothyroid infants (Acta Paediatr 2001; 89: 1431). • Childhood rates for admission and readmission for asthma are highest under the age of 5 years. To examine what may play an important role in these admissions and readmission, 100 patients <4 years old who were admitted to hospital for asthma were followed for 1 year, yielding a total of 136 admissions. In the age group 2-4 years, patients with antibodies against inhalant allergens (RAST), had a significantly higher risk of readmission. Readmissions were higher in the age group 0-1 year than in the age group 2-4 years (p = 0.028). Moreover, in the age group 0-1 year, a trend was observed that inhaled steroids were prescribed less frequently on discharge following first admission in those children who were readmitted than in the children who had a first admission only (p = 0.073). The authors conclude that more "aggressive" therapy with anti-inflammatory drugs and close medical follow-up after discharge seem to be indicated (Pediatr Pulmonol 2001; 31:30). Gaurav Gupta, |
